Provider Demographics
NPI:1487941043
Name:PREMIER PAIN & WELLNESS CENTER PLLC
Entity type:Organization
Organization Name:PREMIER PAIN & WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VU
Authorized Official - Middle Name:PHI
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-939-9940
Mailing Address - Street 1:1398 ELDRIDGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2547
Mailing Address - Country:US
Mailing Address - Phone:409-939-9940
Mailing Address - Fax:
Practice Address - Street 1:1398 ELDRIDGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2547
Practice Address - Country:US
Practice Address - Phone:409-939-9940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5439208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty